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Tuesday, August 7, 2012

Better Weight Loss Surgery Options for Adolescents with Obesity

This month, Sheikh Zayed Institute Principal Investigator Evan Nadler, MD, published a study in the journal Surgery about the effectiveness of laparoscopic sleeve gastrectomy for teens. Well documented complications for patients undergoing gastric bypass make that procedure less than ideal for teens with morbid obesity who require surgery to combat their weight, and have led to surgeons exploring other surgical options. However, in his own practice, Dr. Nadler found that sleeve gastrectomy had many of the same benefits as the more invasive gastric bypass--patients lost an average of 65 lbs, or 40 percent of their weight and reduced their obesity related complications significantly--and fewer negative side effects, for the teens he treats through his Weight Loss (Bariatric) Surgery Program.

Like most of our principal investigators, Dr. Nadler is not only an investigator, but also a pediatric surgeon as well as the co-director of the Children’s National Obesity Institute. He is one of the few doctors in the country who performs bariatric surgeries for adolescents who qualify for this surgical weight loss option. His experiences as a surgeon and as an advocate for change in how this continuing epidemic is addressed around the world, make him uniquely able to see the challenges of obesity—particularly how every person is different, has different complications, and responds to treatments differently. This motivates him to try and get ahead of the disease, and advance the treatment options through finding new, better methods, but also getting more precise in how doctors decide which treatment will work best. The next level, he says, is personalizing these weight loss tactics for each child (or patient).

His research in the Systems Biology initiative of the institute uses genetic analysis to see if it is possible to predict how well someone will respond to a particular weight loss strategy, for example one bariatric surgery procedure over another (i.e. sleeve gastrectomy). It might be, that for some people, surgery isn’t the best option and for others, it may be the only option. Another recently funded project is looking at the fat tissue in patients of differing weights and ethnicities to determine why different people get sick with different diseases if they are obese.

“We want to use our surgical experience to identify the safest and most effective surgeries to help these teens find a way to a healthier life, as soon as possible,” he said.